title: Kidney function and the risk of cardiovascular disease in patients with type 2 diabetes.
abstract: The association of estimated glomerular filtration rate (GFR) with cardiovascular disease risk among patients with type 2 diabetes is unclear. Here we prospectively investigated the race-specific association of estimated GFR with the risk of coronary heart disease and stroke among 11,940 Caucasian and 16,451 African-American patients. During mean follow-up of 6.1-6.8 years, 6647 coronary heart disease and 2750 stroke incident cases were identified. Age- and sex-adjusted hazard ratios of coronary heart disease associated with baseline estimated GFR (90 or more, 75-89, 60-74, 30-59, and 15-29 ml/min per 1.73 m2) were 1.00, 1.04, 1.13, 1.37, and 2.07 (significant trend) for African Americans, and 1.00, 1.09, 1.10, 1.31, and 2.18 (significant trend) for Caucasians, respectively. A significantly increased stroke risk was observed among both African-American and Caucasian participants with an estimated GFR under 60 ml/min per 1.73 m2. When using the updated mean values of estimated GFR, these significant associations became stronger. Participants with mildly decreased estimated GFR (60-89 ml/min per 1.73 m2) during follow-up were also at a significantly higher risk of coronary heart disease and stroke. Thus, even mildly reduced estimated GFR at baseline (under 75 ml/min per 1.73 m2) and during follow-up (under 90 ml/min per 1.73 m2) increased the risk of incident coronary heart disease and stroke among both African-American and Caucasian type 2 diabetes patients.
authors.affiliation: 1] Pennington Biomedical Research Center, Population Science, Baton Rouge, Louisiana, USA [2] School of Human Ecology, Louisiana State University Agricultural Center, Baton Rouge, Louisiana, USA.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Pennington Biomedical Research Center, Population Science, Baton Rouge, Louisiana, USA.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Katzmarzyk
authors.affiliation: 1] Pennington Biomedical Research Center, Population Science, Baton Rouge, Louisiana, USA [2] Health Care Service Division, Louisiana State University Health Science Center, Baton Rouge, Louisiana, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Horswell
authors.affiliation: Pennington Biomedical Research Center, Population Science, Baton Rouge, Louisiana, USA.
authors.forename: Wenhui
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Earl K Long Medical Center, Louisiana State University Health Science Center, Baton Rouge, Louisiana, USA.
authors.forename: Jolene
authors.initials: J
authors.lastname: Johnson
authors.affiliation: Pennington Biomedical Research Center, Population Science, Baton Rouge, Louisiana, USA.
authors.forename: Gang
authors.initials: G
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People; D003327:Coronary Disease / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000208:ethnology*; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000503:physiopathology*; D008137:Longitudinal Studies; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D013997:Time Factors; D044465:White People; D001741:Black or African American